Invasive Blood Pressure 9650-0219-01 Rev.
The issue date or revision level for this operation guide is shown on the front cover. ZOLL and M Series are registered trademarks of ZOLL Medical Corporation. © 2007 by ZOLL Medical Corporation. All rights reserved.
Table of Contents PREFACE ...................................................................................................................................................... V How Do I Use This Manual? ............................................................................................................................ v Safety Summary...............................................................................................................................................
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Preface How Do I Use This Manual? This manual insert describes the set-up and use of the M Series Invasive Blood Pressure option. If you already know how to use the M Series, start by reading the Safety Summary, Indications for Use and Introduction sections of this insert. Familiarize yourself with all the procedures in this insert before you use the IBP option. Consult the Troubleshooting section if the M Series fails to operate as expected.
Safety Summar y (cont.) • If the accuracy of measurements is suspect, first check the IBP waveform for artifact such as catheter whip. Then check the catheter, tubing, transducer, cabling and M Series IBP option for proper functioning. • Do not immerse the M Series device, batteries, cables, or transducers in water, solvents, or cleaning solutions. • If the M Series device gets wet accidentally, wipe it down with a clean towel.
Introduction What Can I Do with the IBP Option? Using the IBP option you can do the following: • Monitor two different invasive pressure channels simultaneously. • Display two pressure traces and one ECG trace simultaneously. • Label each Pressure channel. • Adjust the scaling of the pressure traces. • Display systolic, diastolic and mean blood pressure values on the screen. • Store IBP measurements in code summary, PCMCIA memory card and trend memory.
Preparing to Take Measurements The IBP option has two Pressure channels (P1 and P2). Either channel may be used for any type of pressure measurement (arterial, pulmonary arterial, central venous, or intracranial). Each channel has its own connector, cabling, and transducer. For each channel used you must connect the cabling and transducer to the M Series unit, and zero a transducer before you take a measurement.
4. Verify that neither the CHECK TRANSDUCER nor the REPLACE TRANSDUCER messages display. If desired, repeat steps 1 - 4 to connect a second transducer. The ZERO P1 or ZERO P2 message displays. No pressure measurements will appear until the transducer has been zeroed. Setting up the transducer and catheter Follow manufacturer’s directions for use and your hospital’s protocols on how to setup, prime and flush the transducer and make connections to the pressure monitoring catheter.
Zeroing the Transducer To ensure that the M Series unit measures pressure accurately, you must zero the transducer before each use. The M Series automatically displays ZERO P1 or ZERO P2 when zeroing is necessary. If you change or disconnect a transducer, you must zero the new transducer before use. If you move a transducer to a different monitor, you must zero the transducer again even if you have already done so on another unit.
Taking Measurements If the catheter, transducer and IBP cable are properly attached, the IBP traces display immediately. The IBP numerical values display once the transducer has been zeroed. Unless it is an emergency situation where quick reaction is essential, you should always check that the settings are set properly. You can access all IBP settings through the IBP menu.
Reading the Display Pressure channels 1 and 2 each have their own data display area and waveform display area. Either channel may be used for any type of pressure measurement (arterial, pulmonary arterial, central venous, or intracranial). The IBP Data display areas display the following information: • Systolic blood pressure value. • Diastolic blood pressure value. • Mean blood pressure value. • Alarm status. • Unit of measurement.
The source of the displayed Heart Rate values depends upon the signals being monitored by the M Series unit: • If the ECG signal is present, the ECG heart rate displays. • If the ECG signal is not present, but pulsatile IBP signal is present, the IBP pulse rate displays (regardless of whether the SpO2 signal is present). P1 takes precedence over P2. • If neither the ECG nor pulsatile IBP signals are present, the SpO2 pulse rate displays.
Changing the Display You can change how the M Series unit displays IBP data and traces. Any changes to these settings remain in effect until either the settings are changed or 10 seconds after the M Series is turned off. Changing the displayed traces When in Monitor or Defib mode, the M Series unit displays three traces. While Trace 1 always displays ECG, you can select the type of waveform displayed for Traces 2 and 3. When the M Series unit is in Pacer mode, display messages take the place of Trace 3.
Changing the trace labels Each Pressure channel has a unique label in the IBP display area (see the "Reading the Display" on page 6 for further details). The generic labels are “P1” for Pressure channel 1 and “P2” for Pressure channel 2. These labels appear in the IBP display areas, summary reports, and strip charts. For ease of use, you can set these labels to indicate the type of pressure measurement in use.
Changing the displayed range Each IBP trace has a range that consists of upper and lower limits. By changing the displayed range, you can change the size of the IBP waveform. To change the displayed range: 1. Press the Range softkey. If the Range softkey is not displayed, see "Displaying the IBP Menu" on page 3. The Range menu displays (see Fig. 12): Figure 12: Range Menu 2. Press the Select softkey to select the pressure channel whose range you want to change. 3. Press the Enter softkey.
Setting Alar ms Before taking measurements, check that all IBP alarms settings are appropriate for the situation. You can set the alarms for Pressure channel 1, Pressure channel 2 and NIBP separately. See M Series Operator’s Guide for instructions on setting alarms. CAUTION! Before the M Series with IBP option is initially put into service, the IBP alarm limit defaults should be configured per institutional guidelines. See the M Series CCT Configuration Guide for further details.
Alarm Limit: Default Setting: Range (increments of 5): Low -50 mmHg; -6.7 kPa -50 to 295 mmHg; -6.7 to 39.2 kPa When the M Series is turned on, all alarm functions are disabled and the alarm limits are set to their default values. Any changes to these settings remain in effect until either the settings are changed or 10 seconds after the M Series is turned off. Setting alarm limits You can change all the alarm limits using the standard M Series procedures.
Printing IBP Data See the M Series Operator’s Guide Recorder Operation section for instructions on how to print data. If you are currently displaying IBP traces, press the RECORDER button to print a strip chart that includes the following values for the currently displayed trace: • One or two IBP traces (whichever is currently displayed). • Systolic blood pressure. • Diastolic blood pressure. • Mean pressure. • Time of measurement.
Specifications For a list of alarm defaults and ranges, see "Setting Alarms" on page 11.
Software License Read this License agreement carefully before operating any of the M Series products. Software incorporated into the system is protected by copyright laws and international copyright treaties as well as other intellectual property laws and treaties. This software is licensed, not sold.
Ordering Accessories To order accessories for the M Series IBP option call ZOLL Customer Service at 1-800-348-9011. Customers outside the United States should call the nearest authorized ZOLL Medical Corporation sales representative.
Troubleshooting The following table lists the IBP messages, the problem each message indicates, and the actions you should take to fix the problem. Read this section carefully before monitoring patients. For further assistance, call ZOLL Technical Service at 1-800-348-9011. Customers outside the United States should call the nearest authorized ZOLL Medical Corporation sales representative.
Message/Symptom: Problem: User Action: BP numerical readout displays as “-----” Transducer has not been zeroed. Zero the transducer. Arterial BP waveform distorted. Catheter whip. Overdamped system. Underdamped system. Follow institutional procedures to eliminate catheter whip. Check for the presence of blood clots. Check for blood remaining in the catheter following blood sampling. Check for air bubbles in the entire fluid circuit. Eliminate these as necessary.
Index A D L Accessories, ordering 16 Accuracy specification 14 suspect readings vi Alarm auto setting 12 default 12 disabling 12 enabling 12 range 12 setting 11 suspended v suspending 12 Alarm limit defaults 11 setting 11 Alarm limits 12 Alarm status, reading on display 7 Anesthetics, use with IBP v ART, meaning of 9 Arterial waveform distorted 18 Auto alarm setting, description of 12 Daily checkout procedure 13 Default alarm settings 11 unit of measurement 7 Defibrillation defib-proof parts vi warning
ZOLL technical service 17, 18 Pressure, operating 14 Printing IBP data 13 types of measurements printed 13 sensitivity 14 setting up 2 using two channels 2 zeroing 4 Troubleshooting 17 R U Range alarm 11 changing IBP trace 10 Range menu, illustration 10 Range Options menu, illustration 10 Recording, IBP data 13 Regulatory standards 14 REPLACE P1 TRANSDUCER message signficance of 17 REPLACE P2 TRANSDUCER message significance of 17 REZERO P1 message, significance of 17 REZERO P2 message, significance of 1
